<form method="post" <?php if( isset($action) ) echo 'action="' . $action . '"' ?>>
	<div>
		<label style="display:block;">Reason:</label>
		<textarea style="width: 70%; height: 240px;" name="reason"><?php if( isset( $reason ) ) echo $reason ;?></textarea>
	</div>
	<div>
		<input type="submit" name="confirm-yes" value="Ban" />
		<input type="submit" name="confirm-no" value="Cancel" />
	</div>
	<?php 
if( isset( $hiddenInputs ) ) {
	foreach( $hiddenInputs as $key => $val ) {
?>						<input type="hidden" name="<?php echo $key ?>" value="<?php echo $val ?>" />
<?php	
	}
}
?>
</form>